Provider Demographics
NPI:1891539425
Name:SANTA CRUZ MADRIGAL, ANGELA (RBT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SANTA CRUZ MADRIGAL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 N SILVERBELL RD STE 175
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7379
Mailing Address - Country:US
Mailing Address - Phone:520-540-4998
Mailing Address - Fax:
Practice Address - Street 1:8235 N SILVERBELL RD STE 175
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7379
Practice Address - Country:US
Practice Address - Phone:520-540-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT24-331572106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician